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Adult Tachycardia (With Pulse) Algorithm

The document provides guidelines for treating adult tachycardia (fast heart rate) with a pulse. It outlines assessing the patient using ABCDE approach. It then provides an algorithm for identifying and treating the underlying cause, including using synchronized DC shock, amiodarone, adenosine, or seeking expert help depending on factors like ECG findings and whether the rhythm is stable or unstable. The algorithm guides clinicians on how to determine if the QRS complex is narrow or broad, and whether the rhythm is regular or irregular in order to select the appropriate treatment strategy.

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James Choi
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903 views1 page

Adult Tachycardia (With Pulse) Algorithm

The document provides guidelines for treating adult tachycardia (fast heart rate) with a pulse. It outlines assessing the patient using ABCDE approach. It then provides an algorithm for identifying and treating the underlying cause, including using synchronized DC shock, amiodarone, adenosine, or seeking expert help depending on factors like ECG findings and whether the rhythm is stable or unstable. The algorithm guides clinicians on how to determine if the QRS complex is narrow or broad, and whether the rhythm is regular or irregular in order to select the appropriate treatment strategy.

Uploaded by

James Choi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

2010 Resuscitation

Guidelines
Resuscitation Council (UK)

Adult tachycardia Assess using the ABCDE approach


Give oxygen if appropriate and obtain IV access
(with pulse) Monitor ECG, BP, SpO2 , record 12-lead ECG
Identify and treat reversible causes (e.g. electrolyte abnormalities)
algorithm
Adverse features?
Synchronised DC Shock Yes / Unstable Shock
Up to 3 attempts Syncope
Myocardial ischaemia
Heart failure
Amiodarone 300 mg IV over 10-20 min
and repeat shock; followed by: No / Stable
Amiodarone 900 mg over 24 h
Broad Is QRS narrow (< 0.12 s)? Narrow

Broad QRS Regular Narrow QRS Irregular


Irregular Regular Is rhythm regular?
Is rhythm regular?

Use vagal manoeuvres Irregular Narrow Complex


Adenosine 6 mg rapid IV bolus; Tachycardia
if unsuccessful give 12 mg;
Probable atrial fibrillation
Seek expert help
!
if unsuccessful give further 12 mg.
Monitor ECG continuously Control rate with:
-Blocker or diltiazem
Consider digoxin or amiodarone
Sinus rhythm restored? if evidence of heart failure
Possibilities include: If ventricular tachycardia
AF with bundle branch block (or uncertain rhythm): Yes No
Amiodarone 300 mg IV
treat as for narrow complex
Pre-excited AF
consider amiodarone
over 20-60 min;
then 900 mg over 24 h Probable re-entry paroxysmal SVT:
Record 12-lead ECG in sinus
Seek expert help
!
Polymorphic VT If previously confirmed rhythm
(e.g. torsade de pointes - SVT with bundle branch block: If recurs, give adenosine again &
give magnesium 2 g over 10 min) Give adenosine as for regular consider choice of anti-arrhythmic Possible atrial flutter
narrow complex tachycardia prophylaxis Control rate (e.g. -Blocker)

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